How to Stop Snoring

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Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Snoring is extremely common and 70% of folks with obstructive sleep apnea (OSA) snore. On the other hand, those who suffer from snoring do not necessarily have OSA. Snoring is caused by the vibration of soft tissues obstructing the throat during sleep.

Patients and their partners often seek help from their doctor with the primary complaint of snoring. Remember, if you have significant obstructive sleep apnea (OSA) wearing a nighttime CPAP device is the solution. However, if snoring in the absence of significant sleep apnea is your problem, treatment may be much easier.

It’s impossible to discuss effective snoring treatment without looking at the role of the nose in snoring. The nose is the first anatomical boundary of the upper airway and stuff congest nasal passages may contribute to snoring.

So, let’s look at the evidence. How do you stop snoring?

Weight loss

…But only in pre-obese or obese snorers. What does that mean? Losing weight does help improve snoring, but only to a certain point. In obese and pre-obese folks, lowering boxy mass index (BMI) to 25 is all it takes, and there is no improvement with extra weight reduction after that. Interestingly, weight reduction is not helpful in adult snorers with a normal BMI. What is your body mass index? Use this to find out.

Nasal dilators aka “breathe right strips”

Yes, they work and you can buy them over the counter. Both internal (NoZovent, Mute) and external (Breathe Right Strips) nasal dilators improve snoring. When studied, the internal (inside the nose) dilators improved snoring more significantly than the external dilators like Breathe Right, but both do help. Worth a try for sure.

Limiting alcohol and hypnotics at night

What does this mean? Any sleep aid you are using, like Zolpidem, Zaleplon, Eszopiclone, or alcohol will worsen snoring for sure.

Nasal steroid sprays

Nasal steroid sprays have been shown to decrease mouth breathing and increase nasal breathing at night which improves snoring. Using a daily nasal budesonide spray (Rhinocort), fluticasone (Flonase) or triamcinolone (Nasacort), can decrease snoring frequency and increase rapid eye movement sleep (deep sleep).

Avoiding the supine position

Sleeping on your back (supine) shrinks the airway by a third and I’m always impressed when reviewing the sleep studies of my patients to see the difference in snoring and apnea when folks are sleeping on their backs. Train yourself not to do this.

Oral appliances

These take a bit more work to get as you will need to find a specialist who can fit you for these. “Mandibular advancement devices” are effective in reducing snoring and sleep apnea. These oral appliances are made individually by a dental technician and are usually upper and lower devices that work to move the lower jaw forward.

Oropharyngeal (mouth and throat) exercises

This is the current hot topic in snoring treatment, yet it will take getting a referral to someone who knows what they are doing. Studies show that patients attending weekly visits where they were trained to do eight minutes of oropharyngeal exercises three times a day had significant improvement in snoring.  Tongue and mouth/throat exercises have been shown to decrease snoring by 50%. It’s worth asking your primary care doc for a referral for this is you’ve failed other interventions.

Hope this helps.

Dr O.

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